Physiologically-obtainable polyphenol exposures modulate reactive oxygen and nitrogen species signaling in the C2C12 model of skeletal muscle ageing

Age-related frailty is a significant health and social care burden, with limited treatment options. There is a lack of suitable cell culture model for screening large numbers of test compounds to identify those which promote healthy skeletal muscle function. This paper describes the characterization of reactive oxygen and nitrogen species (RONS) signalling changes in young and aged myoblasts and myotubes using C₂C₁₂ cells, and the application of aged cultures to assess the effect of dietary polyphenols on RONS signalling. Aged myoblasts and myotubes showed significantly increased reactive oxygen species (p < 0.01 and p < 0.001 respectively), nitric oxide (p < 0.05 for myoblasts and myotubes), and lipid peroxidation (p < 0.05 for myoblasts and myotubes). Nine polyphenols were assessed in aged myoblasts and myotubes using concentrations and incubation times consistent with known pharmacokinetic parameters for these compounds. Although several polyphenols were seen to reduce single markers of RONS signalling, only kaempferol and resveratrol significantly reduced multiple markers in both cell models. Modulation of enzymatic antioxidant activities was assessed as a possible mechanism of action, although superoxide dismutase and catalase activities were significantly reduced in aged (versus young) myotubes (p < 0.01 and p < 0.05 respectively), no effect of polyphenol treatment on these enzyme activities were observed. Overall, this research has shown the utility of the C₂C₁₂ model (myoblasts and myotubes) for screening compounds in aged muscle, and that resveratrol and kaempferol (using pharmacokinetically-informed exposures) can modulate RONS signalling in skeletal muscle cells after an acute exposure.

Cardiovascular and liver disease among pre-hospital trauma deaths: A review of autopsy findings

Introduction

Pre-existing disease is a common contributor to mortality and morbidity after injury and resuscitation of injured patients are often altered in hospital based on comorbidities. However, this is uncommon in the pre-hospital phase of care where patients are managed according to clinical practice guidelines. This study aimed to quantify the prevalence of cardiovascular disease (CVD) and liver disease among trauma patients attended by pre-hospital clinicians but who died prior to reaching hospital and assess associations with age.

Methods

This was a retrospective review of pre-hospital trauma deaths in the state of Victoria, Australia between 01 Jan 2008 and 31 Dec 2014. The inclusion criteria were (a) patients attended by pre-hospital clinicians, (b) deceased before arrival to hospital, (c) evidence of recent trauma and (d) underwent a full autopsy. Cardiovascular and liver disease status were extracted from autopsy reports.

Results

There were 1043 patients included in this study. Most patients were male (77.1%). Intentional self-harm was significantly more common in patients aged ≥65 years (17.4%). CVD was prevalent in 495 (47.5%; 95%CI: 44.4–50.5) cases with myocardial fibrosis the most common abnormality detected. All sub-groups of CVD demonstrated a significant association with increasing age, except right ventricular hypertrophy. Liver disease was present in 235 (22.5%; 95%CI: 20.1-25.2) patients and most common among patients aged 35–64 years.

Discussion

CVD was prevalent in almost half of all injured patients included in this study while liver disease was present in about a fifth. The prevalence of CVD was associated with increasing age, while liver disease was more common among middle-aged patients. This high prevalence in our population indicates that pre-existing cardiovascular and liver disease be considered when tailoring pre-hospital life-saving interventions for injured patients.

Design and characterization of a dead-time regime enhanced early photon projection imaging system

Scattering of visible and near-infrared light in biological tissue reduces spatial resolution for imaging of tissues thicker than 100 μm. In this study, an optical projection imaging system is presented and characterized that exploits the dead-time characteristics typical of photon counting modules based on single photon avalanche diodes (SPADs). With this system, it is possible to attenuate the detection of more scattered late-arriving photons, such that detection of less scattered early-arriving photons can be enhanced with increased light intensity, without being impeded by the maximum count rate of the SPADs. The system has the potential to provide transmittance-based anatomical information or fluorescence-based functional information (with slight modification in the instrumentation) of biological samples with improved resolution in the mesoscopic domain (0.1-2 cm). The system design, calibration, stability, and performance were evaluated using simulation and experimental phantom studies. The proposed system allows for the detection of very-rare early-photons at a higher frequency and with a better signal-to-noise ratio. The experimental results demonstrated over a 3.4-fold improvement in the spatial resolution using early photon detection vs. conventional detection, and a 1000-fold improvement in imaging time using enhanced early detection vs. conventional early photon detection in a 4-mm thick phantom with a tissue-equivalent absorption coefficient of μ_a = 0.05 mm^-1 and a reduced scattering coefficient of μ_s' = 5 mm^-1.

Abstract 259: Inflammation and Preoxidation Are Increased in High-Density Lipoproteins From Chronic Heart Failure Subjects

Chronic heart failure (CHF) is a global term for the physiological state in which cardiac output is insufficient to meet the needs of the body and lungs. While oxidative stress, defined as an excess production of reactive oxygen species relative to antioxidant defence, has been shown to play an important role in the pathophysiology of CHF. However, although high density lipoproteins (HDL) have important cardioprotective properties, inflammation and oxidative stress can induce dramatic changes, which negate their antiatherogenic properties. Thus, such impairment to HDL may provide an important link between inflammation and oxidative stress in the pathogenesis of CHF.

This pilot study investigated the antiatherogenic properties of HDL in CHF.

Ten control subjects (BNP<100 nM) were matched for age and gender with 22 CHF subjects (BNP>100 nM). HDL 2 and HDL 3 were isolated from serum by rapid ultracentrifugation. SAA was measured by an ELISA procedure, paraoxonase-1 (PON-1) activity, hydroperoxide (HPO) and conjugated diene (CD) concentration were measured by spectrophotometric assays.

Results: Compared to the control subjects, BNP was higher in the CHF subjects [50 (11) vs. 2439 (900) nM; p=0.015] and in HDL 2 and HDL 3 , SAA-related inflammation was increased, while the activity of the antioxidant enzyme PON-1 was decreased and CDs, one of the markers of lipid peroxidation, were increased (see table).

Conclusion: This pilot study has shown that HDL displayed a proatherogenic phenotype in CHF subjects, which we suggest may be biologically relevant in the pathophysiology of CHF.

Exercise and postprandial lipaemia: effects on peripheral vascular function, oxidative stress and gastrointestinal transit

Postprandial lipaemia may lead to an increase in oxidative stress, inducing endothelial dysfunction. Exercise can slow gastric emptying rates, moderating postprandial lipaemia. The purpose of this study was to determine if moderate exercise, prior to fat ingestion, influences gastrointestinal transit, lipaemia, oxidative stress and arterial wall function. Eight apparently healthy males (age 23.6 ± 2.8 yrs; height 181.4 ± 8.1 cm; weight 83.4 ± 16.2 kg; all data mean ± SD) participated in the randomised, crossover design, where (i) subjects ingested a high-fat meal alone (control), and (ii) ingested a high-fat meal, preceded by 1 h of moderate exercise. Pulse Wave Velocity (PWV) was examined at baseline, post-exercise, and in the postprandial period. Gastric emptying was measured using the ¹³C-octanoic acid breath test. Measures of venous blood were obtained prior to and following exercise and at 2, 4 and 6 hours post-ingestion. PWV increased (6.5 ± 1.9 m/sec) at 2 (8.9 ± 1.7 m/sec) and 4 hrs (9.0 ± 1.6 m/sec) post-ingestion in the control group (time × group interaction, P < 0.05). PWV was increased at 2 hrs post-ingestion in the control compared to the exercise trial; 8.9 ± 1.7 vs. 6.2 ± 1.5 m/sec (time × group interaction, P < 0.05). Lipid hydroperoxides increased over time (pooled exercise and control data, P < 0.05). Serum triacylglycerols were elevated postprandially (pooled exercise and control data, P < 0.05). There were no changes in gastric emptying, cholesterol, or C-reactive protein levels. These data suggest that acute exercise prior to the consumption of a high-fat meal has the potential to reduce vascular impairments.

Delta 9-tetrahydrocannabinol induces the apoptotic pathway in cultured cortical neurones via activation of the CB1 receptor

Delta 9-tetrahydrocannabinol, the principal psychoactive component of marijuana, exerts a variety of effects on the CNS, including impaired cognitive function and neurobehavioural deficits. The mechanisms underlying these neuronal responses to tetrahydrocannabinol are unclear but may involve alterations in neuronal viability. Tetrahydrocannabinol has been shown to influence neuronal survival but the role of the cannabinoid receptors in the regulation of neuronal viability has not been fully clarified. In this study we demonstrate that tetrahydrocannabinol promotes the release of cytochrome c, activates caspase-3, promotes cleavage of the DNA repair enzyme poly-ADP ribose polymerase and induces DNA fragmentation in cultured cortical neurones. These effects of tetrahydrocannabinol were completely abrogated by the CB(1) receptor antagonist AM-251. The findings of this study demonstrate that tetrahydrocannabinol induces apoptosis in cortical neurones in a manner involving the CB1 subtype of cannabinoid receptor.

Genetic testing, Alzheimer disease, and long-term care insurance

Patients with Alzheimer Disease (AD) often need long-term care, which is poorly covered by private or governmental health insurance. Private long-term care (LTC) insurance is increasingly being marketed to provide some financial support for long term care. LTC insurance does cover AD, but the insurers will not sell policies to people who have already been diagnosed with AD. As a result, LTC insurance might be particularly attractive to individuals who are at heightened risk for developing AD. This makes the issues surrounding predictive genetic testing for AD and the use of test results in determining insurance premiums and eligibility of great concern to patients, clinicians, insurers, ethicists, and patient advocate groups. The paper examines the complexities of these issues.

Interdecadal heterogeneity in mitochondrial DNA of Atlantic haddock (Melanogrammus aeglefinus) from Georges Bank

Atlantic haddock of Georges Bank are characterized by large fluctuations in population size and a recent collapse of the commercial fishery. DNA extracted from dried scales of Georges Bank haddock, archived by the U.S. National Marine Fisheries Service (NMFS), reveals significant heterogeneity in frequencies of four mitochondrial DNA control region haplotypes between 1975 and 1985 cohorts. Several processes may be responsible for this temporal variation, the most attractive hypothesis being that haddock from other geographic regions episodically contribute to the Georges Bank gene pool. Thus, the population of haddock spawning on Georges Bank may not be genetically discrete and, with respect to Atlantic haddock, Georges Bank may not be viewed as a closed system.

Heavy utilization of inpatient and outpatient services in a public mental health service

OBJECTIVE

The purpose of the study was to develop a descriptive profile of heavy users of services in the South Australian Mental Health Services.

METHODS

Case notes for 50 heavy users were reviewed to obtain demographic and diagnostic information and data on service use over a three-year period. To supplement and verify this information, 35 of the patients were given structured interviews.

RESULTS

The mean age of the 50 patients was 34.9 years, and there was a slight predominance of females. Most patients had never married and had been unemployed for a long time. All had a low income. The mean number of years of education was ten. The group was seriously disabled by psychiatric illness. The most common diagnosis was schizophrenia, followed by schizoaffective disorder and bipolar disorder. Comorbid axis I disorder and personality disorder or physical illness was common. Drug and alcohol abuse often complicated patient management and patients' ability to live successfully in the community. The average annual cost per patient was $13,598 (Australian), largely from inpatient care.

CONCLUSIONS

This study contributes to an emerging global profile of the heavy service user. Such a profile may help service systems identify patients in this subgroup and target management strategies to these often very disadvantaged and challenging patients.

A review of studies of heavy users of psychiatric services

OBJECTIVES

This paper reviews studies of patients who are heavy users of psychiatric services and identifies areas in which further research and evaluation are indicated.

METHODS

Extensive searches were conducted of the English language psychiatric and psychological literature before 1994. Important references from initially identified studies were followed up. More than 200 articles were reviewed, 72 of which are described in this review. The 72 papers were selected because they dealt with three questions: What is heavy service use? What patient characteristics contribute to it? What service delivery characteristics contribute to it?

RESULTS AND CONCLUSIONS

Criteria for identifying and defining heavy users of psychiatric services vary among studies. Few studies of heavy service users have attempted to examine use of all psychiatric services, both inpatient and community based. In most studies, 10 to 30 percent of patients are identified as heavy users, those who utilize between 50 and 80 percent of service resources. This group consists of a constantly changing cohort of patients who generally have psychotic illnesses as well as comorbid personality disorders and high levels of drug and alcohol misuse. Few studies have examined social issues such as isolation, homelessness, and social support, although these factors appear to contribute significantly to heavy service use. Few attempts have been made to define heavy-user groups in fiscal terms. More research on heavy users of psychiatric services is clearly needed to improve providers' ability to plan appropriately targeted mental health services for this disabled group of patients who use expensive resources.

Candidial osteomyelitis: a case report

Candidial osteomyelitis is rare but becoming more common. The spinal column is most affected in adults and one such patient is presented. The condition should be suspected if bone infection has followed long intensive care, parenteral feeding with central venous cannulation, the use of many antibiotics in combination and/or concomitant severe eye infection. If diagnosed, correct treatment with antifungal agents is curative.

"Asset stripping" the declining mental hospital

A psychogeriatric day hospital was developed from a long-stay back ward of a large mental hospital whose population of patients had decreased by half. Women in the 70-80 age group with varying degrees of dementia benefited most from such facilities. In view of the current cut-back in Government spending one of the greatest assets in providing a comprehensive service for the elderly mentally infirm may well be found in the declining mental hospital.

Correlation of serum theophylline levels with inhibition of allergen and histamine-induced skin tests

The purpose of this study was to determine if clinically effective serum levels of theophylline have an inhibitory effect on intradermal tests for allergic hypersensitivity. Intradermal testing using the threshold-dilution technique was performed in 9 patients, 7 of whom were sensitive to 2 antigens. Testing was performed over a 6-hour period after theophylline administration and compared with the control results. Inhibition of the end-point was demonstrated with 12 of 16 antigens tested associated with serum theophylline levels ranging from 7 to 20 microgram/ml. Marked inhibition of the intradermal tests, that might have clinical significance, only occurred with 4 antigens.